Medical Assistant
- Must be bilingual/Spanish.
PURPOSE AND SCOPE:
The Medical Assistant I performs duties and responsibilities related to patient care in the ambulatory clinic environment. The incumbent displays responsible behaviors, communicates effectively to others and functions as a member of the healthcare team. The Medical Assistant I functions under the direct supervision and authority of the physician or other licensed provider when performing clinical tasks during patient care. The incumbent maintains an inventory of examination/procedure room supplies, assists in the organization of efficient patient flow, and organizes the clinic environment to assure patient safety. The Medical Assistant I demonstrates problem-solving skills as they relate to patient care activities, provides outstanding customer service skills including empathy, compassion, respect, efficiency and professionalism when interacting with internal and external customers. Provides guidance for and acts as a role model for other medical assistants in the clinical area. Prioritizes (triages) patient needs identified through phone, electronic, and walk-in communication, and returns patient messages timely.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Front Office
- Greet and check in/out patients
- Answer phones and schedule appointments
- Verify insurance and collect copays
- Manage patient records and update demographic information
- Coordinate with clinical staff and providers
- Maintain front office organized and patient flow
Transitional Care Management (TCM)
- Initiate post-discharge outreach within 48 business hours
- Coordinate follow-up visits within required 7-14 day timeframes
- Obtain and review hospital discharge summaries, dialysis unit notes, and specialist consultations
- Document all TMC activities in EMR in compliance with CMS guidelines
- Prior Authorization and Insurance Coordination
- Submit and track prior authorization for imagining (renal, ultrasound, CT, MRI), infusion therapy, medications
- Communicate with payers, pharmacies, and specialty pharmacies
- Prepare clinical documentation to support medical necessity
- Assist with appeals and peer-to-peer coordination as needed
- Notify patients of approval/denial status and coordinate medication access
- Medical Records and Care Coordination
- Manage incoming/outgoing medical records in compliance with HIPAA
- Retrieve hospital, dialysis and transplant records promptly
- Maintain organized and complete EMR documentation
- Assist with quality reporting and value-based metrics
PHYSICAL DEMANDS AND WORKING CONDITIONS:
- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians.
- The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials.
- Travel may be required.
SUPERVISION:
- None
EDUCATION:
- High School Diploma or an equivalent combination of education and experience.
- Certification or licensure as required by state.
EXPERIENCE AND REQUIRED SKILLS:
- 1 – 2 years’ related experience preferred but not required.
- Medical office experience preferred.
- Good verbal and written communication skills.
- Interpersonal and communication skills with patients, families, physicians and other health care team members in order to foster optimal quality of outpatient care.
- Intermediate computer skills and experience with electronic medical office systems such as electronic medical records, scheduling programs, credit card machines, manage phone systems standard office equipment and any new technology that arises.
- 100 % Bilingual/Spanish
